News on ISSUOG CONGRESS, SYDNEY, 2013

1. REPORT FROM ISUOG CONGRESS
IN SYDNEY 2013
To Mai Xuan Hong
Dr. To Mai Xuan Hong
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2. 1st trimester assessment of aneuploidy
• US markers
–
–
–
–
NT, NB, Facial angle
Doppler of DV (a-wave)*
Doppler of tricuspid valve*
Intra-cranial translucency (IT)*
• Biochemical markers
– Fß-hCG and PAPP-A
• Non-invasive prenatal test
(NIPT)
– Decision of invasive test in the
intermediate risk (<1/10-1/1000
followed CFTS)
Dr. To Mai Xuan Hong
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3. 1st trimester assessment of aneuploidy
Dr. To Mai Xuan Hong
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4. 1st trimester assessment of aneuploidy
• Oral presentations
– Screening for adverse pregnancy outcomes at 12ws
(Audibert, Francois)
– Combined first trimester biochemistry, NIPT or both?
(Johnson, Jo-An)
– Sequencing for NIPT: techniques, technologies,
applications and limitations (Johnson, Jo-An)
– First trimester screening for neural tube defect (Meaghen,
Simon)
Dr. To Mai Xuan Hong
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5. 1st trimester assessment of growth and Doppler
• Crown-rump length measurement
• Increased Uterine artery Doppler indices (PI
> 90th or 95th centile) associated with
–
Reduced fetal movement
–
Superimposed pre-eclampsia
–
SGA < 10th centile
–
SGA < 3rd centile
–
Still birth
• Low PAPP-A level (<0.3 MoM) or both of
PAPP-A and free ß-hCG (<0.5MoM)
– related to poor placentation (low birth weight and still birth)
Dr. To Mai Xuan Hong
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6. 1st trimester assessment of growth and Doppler
• Oral presentations
– Assessment of crown-rump length measurement variability (McLennan, Andrew)
– Clinical evaluation of a first trimester algorithm predicting the risk of
hypertension disease of pregnancy (Park, Felicity)
– First trimester screening of pregnancy complication (Hyett, Jon)
– Assessment of 1st trimester uterine artery pulsatility index in Hongkong Chinease
pregnant women(Sahota, Daljit)
– Pulsatility index of the uterine arteries between 11 and 13.6 weeks: comparison
of measurement by transvaginal and transabdominal Doppler ultrasound (Cafici,
Daniel)
– Reduced fetal movement at term association to first trimester uterine artery
Doppler assessment (G Pagani)
– Reduced fetal movement at term: association to first trimester PAPP-A level (G
Pagani)
– Outcomes in cases of low PAPP-A and free ß-hCG in maternal serum at 1st
trimester screening (Deloison)
Dr. To Mai Xuan Hong
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7. 2nd trimester assessment
• Ratio of prenasal thickness (PT) and nasal bone length (NBL) (Down
syndrome)
• Fetal facial shape
– Facial height (FH) and facial width (FW) (FH/FW ratio)
– Forehead assessment (Profile line) (Down syndrome)
• Short femur length associated with
– Chromosomal abnormalities
– SGA
– Early preterm delivery
• Increased 2nd trimester uterine artery Doppler indices (> 90th centile)
associated with placental dysfunction)
• Femoral metaphyseal-epiphyseal angle (> 130◦ in achondroplasia)
• Asymptomatic short cervix length is a predictor of intra-amniotic
inflammation
Dr. To Mai Xuan Hong
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8. 2nd trimester assessment
Dr. To Mai Xuan Hong
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9. 2nd trimester assessment
• Oral presentations
– The prenasal thickness to nasal bone length ratio: 2D versus 3D ultrasound (E
de Jong)
– Fetal facial shape: 3D study of height and width in the 2nd and 3rd trimester of
pregnancy (A De Boagent)
– Forehead assessment in normal and pathological fetuses by the fetal profile
line (E de Jong)
– Outcome of fetuses with short femur length detected at 2nd trimester
malformation scan: a national survey (JM Mathiesen)
– Reduced fetal movement at term: association to second trimester uterine
artery Doppler assessment (G Pagani)
– Femoral metaphyseal-epiphyseal angle: a new prenatal ultrasound finding in
achondroplasia (A Khalil)
– Non-invasive prediction of intra-amniotic infection and/or inflammation in
patient with cervical insufficiency or an asymptomatic short cervix (<15mm) (E
Jung)
Dr. To Mai Xuan Hong
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10. IUGR: detection and management
• Late-onset IUGR = SGA+(EFW<P3, Abnormal
MCA-UtA-UA)
– Poor outcome (neonatal morbility)
– Possible choosing an induction
• TRUFFLE study (Trial of Umbilical and Fetal Flow
in Europe)
– Decision the best timing of delivery in preterm
pregnancies complicated IUGR
– Surveillance test: CTG, UA and DV Doppler
• Aortic intima-media thickness (aIMT) (> 0.8mm)
– Higher SBP and glomerular dysfuction Hong
Dr. To Mai Xuan
10

11. IUGR: detection and management
• Oral presentations
– Are all late-onset IUGR the same? (E Gratacos)
– Clinical lessons from the TRUFFLE study (C Bilardo)
– The use of charts in detecting late-onset IUGR (A
Papageorghiou)
– Prenatal scale for cardiovascular risk in IUGR (E Cosmi)
Dr. To Mai Xuan Hong
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12. Cervical assessment
• Preterm delivery
– Intra-amniotic sludge
• Induction of labor
– TVS assessment
– Comparison of funneling,
length and Bishop’s score
Dr. To Mai Xuan Hong
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13. Cervical assessment
• Oral presentations
– Intra-amniotic sludge observed at cervical ultrasound
and the risk of preterm delivery (F. Audibert)
– Sonographic funneling of uterine cervix as predictor
for success of labor induction (E Kim)
– Pre and post-ripening sonographic assessment of
cervix for predicting successful induction of labor (M
Cordoba)
Dr. To Mai Xuan Hong
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14. Fetal neurosonography
• Probst Bundle
– Agenesis of the corpus callosum
• Pericallosal lipoma
– Shows in 3rd trimester
– Increased echogenicity in corpus callosum
– Invisualised corpus callosum
• MRI in conjunction with US
– www.fetalmri2014.org ( 15-20 Mars 2014,
Canada)
Dr. To Mai Xuan Hong
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15. Fetal neurosonography
• Oral presentations
– Disorders of axonal guidance as visualised by fetal MRI
(D Prayer)
– Periventricular leukomalacia in fetus: prenatal imaging
and diagnostic features (D Pugash)
– US volume navigation with fusion MRI imaging: a
novel approach for prenatal diagnosis (G Malinger)
Dr. To Mai Xuan Hong
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16. IOTA classification
(International Ovarian Tumor Analysis)
• Main IOTA model
Dr. To Mai Xuan Hong
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17. Dr. To Mai Xuan Hong
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18. Simple rule for identifying a benign or malignant tumor
Dr. To Mai Xuan Hong
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19. Simple rule for identifying a benign or malignant tumor
Dr. To Mai Xuan Hong
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20. IOTA classification
(International Ovarian Tumor Analysis)
• Oral presentations
– Predictive value of subjective assessment, IOTA simple
rule, IOTA logistic regression model 1 (LR1), Alcazar’s
GI-RAD model and risk of malignancy (RMI) model in
the preoperative discrimination of adnexal mass (A
Czekierdowski)
– The additive value of HE4 novel tumor marker to the
IOTA simple rules in the management of ovarian
masses (B Erdoli)
Dr. To Mai Xuan Hong
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21. Thank you!
Dr. To Mai Xuan Hong
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